Clinical Advances in Periodontics最新文献

Background: Orthodontic treatment in adults with thin periodontal phenotype presents challenges such as lengthy treatment time and increased risk for gingival recessions. In this case, surgically facilitated orthodontic treatment (SFOT) was proposed to accelerate orthodontic tooth movement while modifying the periodontal phenotype.

Methods: An orthodontic patient was referred for periodontal evaluation of lower anterior teeth, which presented a thin gingival phenotype and bone dehiscence. SFOT was performed on the mandible using particulate allograft combined with platelet rich fibrin (PRF) and collagen membrane to augment soft and hard tissue, thereby preventing future recessions, while accelerating the treatment times.

Results: Six-month and 3-year follow-ups confirmed radiographic bone fill, absence of gingival recession and thick band of keratinized gingiva. SFOT also resulted in a shorter treatment time where desired tooth movements were achieved within 6 months with periodontal stability.

Conclusions: SFOT provided clinical benefits by accelerating orthodontic movement, improving periodontal phenotype, preventing the displacement of teeth beyond the alveolar housing and minimizing the risk for development of dehiscences and gingival recessions.

Key points: Orthodontic movements can create recessions and dehiscence in thin periodontal phenotypes. SFOT can help prevent bone dehiscence and creates a thicker gingival phenotype while accelerating treatment time.

Plain language summary: Adults who face lengthy orthodontic treatments and have thin gums have risks of gum problems. Surgically facilitated orthodontic treatment (SFOT) can help by speeding up tooth movements and improving gum health and thickness. A patient with thin gums and lack of bone in the lower front teeth was evaluated. The SFOT procedure involved using a bone graft, healing factors, and a collagen membrane to strengthen the gums and bones. This approach aimed to prevent future gum problems and speed up orthodontic treatment. Follow-ups at 6 months and 3 years after treatment showed good healing of the gums and bones, with no signs of gum recession and healthier, thicker gums. The desired tooth movements were achieved within 6 months, resulting in a shorter treatment time. The patient's gums remained stable throughout this period. SFOT offered significant clinical benefits, including faster tooth movement and improved gum health. It also helped prevent teeth from moving out of place and minimized the risk of gum recession and bone issues. This approach can be a valuable option for adults with thin gums undergoing orthodontic treatment.

Background: Cheilitis granulomatosa (CG) and plasma cell gingivitis (PCG) are uncommon inflammatory conditions affecting the oral regions. CG manifests as chronic lip swelling with granulomatous inflammation, while PCG presents as erythematous gingiva or gingival enlargement linked to hypersensitivity reactions. Their simultaneous occurrence is exceedingly rare, posing diagnostic and therapeutic challenges.

Methods: A 32-year-old woman presented with recurrent upper lip swelling and gingival enlargement. Clinical examination revealed erythematous gingiva with a cobblestone texture and angular cheilitis. Biopsies confirmed orofacial granulomatosis with epithelioid granulomas and PCG with plasma cell infiltration. Management consists of diet modification and periodontal intervention. Postoperative outcomes demonstrated significant improvement, and allergen elimination strategies were implemented to reduce recurrence.

Results: At 9 months of follow-up of the patient, there was significant improvement in signs and symptoms with no signs of recurrence.

Conclusion: This case highlights the rare co-existence of CG and PCG, emphasizing the need for a comprehensive diagnostic approach to exclude systemic causes. Successful management requires pharmacological treatment, surgical interventions, and dietary modifications. Long-term follow-up is essential to monitor recurrences and maintain clinical stability.

Key points: Because of the rare co-occurrence of cheilitis granulomatosis (CG) and plasma cell gingivitis (PCG), which creates unique diagnostic and therapeutic hurdles, this case offers new information. Additionally, it presents an effective treatment plan that concurrently addresses both problems. A comprehensive strategy is necessary for the successful management of PCG and CG. Systemic disorders must be ruled out since they might exhibit similar symptoms. Dietary changes, nonsurgical, and surgical periodontal therapy are all part of the therapy plan. In order to avoid recurrence and guarantee a long-lasting recovery, long-term monitoring and regular elimination of allergens and irritants are essential. The possibility of the problem recurring is one of the main obstacles to this case's success. Reducing the chance of recurrence requires adhering to dietary changes and getting rid of allergens. Additionally, before initiating any kind of treatment, systemic disorders must be ruled out.

Plain language summary: Cheilitis granulomatosa (CG) and plasma cell gingivitis (PCG) are two uncommon conditions that affect the oral cavity. In this case report, a 32-year-old female patient presented with swelling of the lip and enlargement of the gums. There was a presence of cracks at the corners of the mouth, along with redness of gums with uneven texture. Investigations were done to rule out other possible causes of the same. His

Background: Periodontally accelerated osteogenic orthodontics (PAOO) or surgically facilitated orthodontics involves corticotomies and bone grafts during orthodontic treatment. It aims to enhance the range and rate of tooth movement and improve alveolar bone dimension and gingival architecture. Limited evidence exists on bone dimension changes due to PAOO. This retrospective study assesses PAOO's effects on alveolar bone thickness.

Methods: Patient records from 15 arches treated with PAOO were compared to 15 age and sex-matched control arches treated without PAOO. Pre- and post-orthodontic cone-beam computed tomography images measured radicular bone thickness at central and lateral incisors in sagittal sections at 3, 6, 9, and 12 mm from the cemento-enamel junction (CEJ). The vertical distance of crestal bone from CEJ was also measured. Fenestrations or dehiscence were quantified on buccal root surface cross-sections.

Results: Of the 15 PAOO-treated arches, 10 were augmented on the compression side of tooth movement, while five were augmented on the tension side. In cases augmented on the compression side, the PAOO group showed a significant increase in the buccal radicular bone at 3, 6, and 9 mm from the CEJ. A significant loss in lingual crestal bone height was observed in the PAOO group. Additionally, there was a significant reduction in fenestrations and dehiscence in the PAOO group.

Conclusions: Within our study's limitations, results suggest that PAOO increases alveolar bone thickness and reduces fenestration and dehiscence incidence when performed on the compression side of orthodontic movement. However, it is associated with lingual crestal bone loss. Further prospective studies with standardized protocols are needed to better define PAOO's efficacy.

Key points: Periodontally accelerated osteogenic orthodontics (PAOO) increases the thickness of alveolar bone when performed on the compression side of the orthodontic tooth movement. PAOO may prevent alveolar fenestrations and dehiscence of root surfaces after orthodontic treatment. PAOO may reduce orthodontic treatment time in select cases.

Plain language summary: With an improved awareness of dental esthetics and function, an increased number of adult individuals are seeking orthodontic therapy. Adult patients present with unique challenges for the treating orthodontist such as extensive restorative work, missing teeth, thin alveolar bone, and thin gingival tissues. This might result in increased recession, bone loss and fenestration, and dehiscence. Periodontally accelerated osteogenic orthodontics (PAOO) allows for quicker tooth movement, as well as increasing alveolar bone thickness to prevent subsequent hard and soft tissue deficiencies. In this retrospective study, we compared the effects of orthodontic treatment completed with and without PAOO on alve